in defense of GPs

[Guest guest]

In defence of GPs - which you term as ordinary - overall I

have met more extraordinary GPs than ordinary. I have also come

accross nurses more competent than the doctors they work with.

Additional accreditation looks good on a wall, but it is not guarantee of

quality care. The emails which raise your and Bill's ire, also

contained praise for physicians I have dealt with and am dealing

with.

At 5/27/02 12:13 PM Monday, you wrote:

Barbara,

I agree with you that a movement disorder clinic would be the best place

for

a diagnoses of MSA or any problem with movement. I would not go to

a

neurologist who was a pain specialist for a movement disorder.

You are experienced with working with doctors and know what to look for

in a

doctor. Unfortunately many on the list do not have that experience

or

training and some of the emails which are extremely critical of

neurologists

recently come from people who have not even been diagnosed as

" probable

MSA " . Unfortunately, some of them have mentioned taking

medicines for pain

which can cause symptoms of MSA. I can see where a doctor would be

reluctant

to give out pain medicines on a daily basis to a MSA patient as our

neurologist always pointed out that most pain killers could worsen

MSA

symptoms. We were always advised to use pain killers as little as

possible.

You also realize that with MSA you must accept the fact that there

is

presently no cure for MSA and you must deal with it as best you

can. Some

people have trouble accepting that fact and want a cure now. In

that case,

the doctor may have sarcastically told the person that the only sure

diagnoses is an autopsy, which is true. You also know that

diagnoses of MSA

is difficult at best and you must realize that doctors are human and have

bad

days just like me and you. Fisher got tired of hearing

continuous

complaints about " ALL " neurologists and people seemed to jump

him, yet they

expect to be able to tell MSA patients to use opiates and have people

get

upset at them. Opiates and overdoses of muscle relaxants can hurt

MSA

patients - so doctors who refuse to give them to MSA patients are doing

their

job. Pain from MSA usually comes from dystonia which can usually

be

controlled with much safer treatments. If using opiates becomes

necessary -

it should be limited to necessary short term use only. Only a

doctor is

qualified to make that decision to use something that powerful, knowing

it

can make the MSA symptoms worse and balance use against the possibility

of

addiction.

I do feel strongly that making blanket statements about bad neurologists

is

harmful to the list. I am sure there are some out there, but I have

dealt

with 8 neurologists for my wife and children and six of the eight were

great

- the other two were at least competent. But until I learned about

MSA and

brain disorders, I could not have told you if they were competent and

most

here on the list need to trust their neurologists. That is why I

feel we

should help the people by examining the care they receive and not rush

to

judge the neuro. If they are trying PD or MS medicines; advising

exercise,

liquids and good diet; and working with the patient - I assume they are

doing

the best they can. As a movement disorder specialist said at the

Boston

conference " MSA is the worst trick that mother nature can play on a

human

being " .

I am all for talking out problems with communication on the list.

We can

help each other get good care (which CAN come from an ordinary GP who

is

willing to work with you). It IS best to see a movement disorder

specialist

for a diagnoses. But " ALL " neurologists are not

" bad " and I feel most are

good, just as any field or profession.

Take care, Bill Werre

============================================

woodford wrote:

> Bill,

>

> The point I was trying to make was that most neurologists are

supposedly

> brainy people, who usually are very short on people skills, and

sometimes

> on brain skills as well. Sorry if I hurt any neuro's feelings.

This

> comes, as I said, from a lifetime experience dealing with

neurologists as

> a colleague, as a patient, and as a patient advocate. I won't go

into

> details.

>

> I was commiserating with who said that one neurologist said

that he

> could diagnose her husband if they would let him do an autopsy. What

kind

> of creep would say that?

>

> It's best to stick with the medical centers who have some reputation

in

> the MSA diagnosis field. Some local neurologists have no inkling of

MSA

> and, if they have a patient, don't even bother to come up to speed

on the

> latest medical treatment. On the other hand, some non-neurologists

we

> have met are great, such as an ER doctor in Northern Wisconsin who

knew

> what was going on when my husband had a mental blackout.

>

> Sorry, but sour on docs.

>

> Barbara Woodford

>

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